Investigating heart inflammation after a stroke

Magnetic Resonance Imaging Evidence of Cardiac Inflammation Post-Stroke

This study is trying to see if heart inflammation is linked to strokes by comparing heart health in stroke patients and those with other neurological symptoms.

Quick facts

• Study type: Observational
• Enrollment: 44 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's (other)
• Locations: 1 site (London, Ontario)
• Trial ID: NCT05714618 on ClinicalTrials.gov

What this trial studies

This observational study aims to enroll 44 patients who have experienced an acute ischemic stroke in the middle cerebral artery, comparing inflammatory markers within 10 days and 60±15 days post-stroke. Additionally, 24 control patients with acute neurological symptoms but no brain infarct will be included for comparison. The study will utilize gadolinium-enhanced cardiac MRI and assess B-Type Natriuretic Peptide and systemic inflammatory markers to understand the relationship between stroke and cardiac inflammation.

Who should consider this trial

Good fit: Ideal candidates are individuals who have experienced an acute ischemic stroke in the middle cerebral artery territory.

Not a fit: Patients with a history of significant cardiovascular issues or recent infections may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could enhance understanding of cardiac inflammation post-stroke, potentially leading to improved patient management and outcomes.

How similar studies have performed: While this approach is innovative, similar studies have not been widely reported, indicating a novel exploration in this area.

Eligibility criteria

Inclusion Criteria:

• Acute ischemic stroke in the right or left MCA territory. Acute ischemic stroke is defined as acute onset focal symptoms matching an acute brain infarct documented on Head computed tomography or diffusion-weighted imaging (DWI) MRI of the brain showing restricted diffusion.

Exclusion Criteria:

* History of known atrial fibrillation, prior myocardial infarction, coronary artery disease, heart failure, prior cardiovascular surgery or percutaneous intervention.
* Previous stroke (occurred within 3 months before the index event)
* Impaired renal function defined as a creatinine clearance \<97 mL/min in men or \<88 mL/min in women, according to the Cockcroft formula.
* hs-TnT \>100 on routine acute stroke baseline bloodwork upon admission.
* Clinically or neurologically unstable patients as per the treating physician.
* Ongoing infection or recent infection within the previous 3 months
* Surgery within 3 months before the stroke
* Concurrent and active inflammatory conditions (connective tissue diseases, rheumatological disease, etc.) or use of anti-inflammatory medications
* Pregnancy, Stage IV renal insufficiency, eGFR \<30, and any other contraindications to the use of gadolinium.
* Stroke with symptomatic hemorrhagic transformation
* Subjects will be excluded if they fail the LHSC standard MRI screening questionnaire (cardiac pacemakers/wires, aneurysm clips, shunt/surgical clips, shrapnel/bullets, dentures or metal braces, intra-uterine devices, heart valves, ear implants, prostheses, medication patches such as Nicoderm, Habitrol, or Transderm-Nitro, claustrophobia, history of a head or eye injury involving metal fragments.

Where this trial is running

London, Ontario

• Heart & Brain Lab, Western University — London, Ontario, Canada (RECRUITING)

Study contacts

• Principal investigator: Luciano Sposato, MD — London Health Sciences Center, Western University
• Study coordinator: Diana Ayan, MSc

Conditions: Stroke, Ischemic, Inflammation, Myocardial Injury